Identification of ruptured intracranial aneurysms using the aneurysm-specific prediction score in patients with multiple aneurysms with subarachnoid hemorrhages- a Chinese population based external validation study

Abstract

Background For patients with aneurysmal subarachnoid hemorrhages (SAHs) and multiple intracranial aneurysms (MIAs), a simple and fast imaging method that can identify ruptured intracranial aneurysms (RIAs) may have great clinical value. We sought to use the aneurysm-specific prediction score to identify RIAs in patients with MIAs and evaluate the aneurysm-specific prediction score. Methods Between May 2018 and May 2021, 134 patients with 290 MIAs were retrospectively analyzed. All patients had an SAH due to IA rupture. CT angiography (CTA) was used to assess the maximum diameter, shape, and location of IAs to calculate the aneurysm-specific prediction score. Then, the aneurysm-specific prediction score was applied to RIAs in patients with MIAs. Results The IAs with the highest aneurysm-specific prediction scores had not ruptured in 17 (12.7%) of the 134 patients with 290 MIAs. The sensitivity, specificity, false omission rate, diagnostic error rate, and diagnostic accuracy of the aneurysm-specific prediction score were higher than those of the maximum diameter, shape, and location of IAs. Conclusions The present study suggests that the aneurysm-specific prediction score has high diagnostic accuracy in identifying RIAs in patients with MIAs and SAH, but that it needs further evaluation.

Application of zone classification in multiple intracranial aneurysmal subarachnoid hemorrhage treatment strategies

“…In our center, determining which aneurysm is at risk of ruptured depends mainly on clinical experience, with SAH location and morphology serving as the two most important factors. While assessing risk for aneurysm rupture is highly complex, researchers have addressed this issue [ 20 , 21 ]. Some scoring systems for patients with MIAs have proven weak [ [22] , [23] , [24] ].…”

Vascular headache an traumatic brain injury

“…4,5 In the case of stroke, we can subdivide it into hemorrhagic and ischemic. Among hemorrhagic hemorrhages, we find (1) spontaneous intracerebral hematomas [6][7][8] and (2) hemorrhages due to rupture of an intracranial aneurysm, with subarachnoid hemorrhage leading 9,10 .…”